Prior to a meeting this morning I was enjoying a cup of coffee and the USA Today newspaper for March 22, 2019. The front page headline: “Insulin Cost Has Diabetics Desperate.” This article triggered my emotions for several reasons. Please click that link and read the article.
Firstly, I’ve noticed an increase in the number of patients I see in our Olympia Fields office with diabetes and the eye related effects of diabetes. Upon discussing life with diabetes with many patients, some have no issues with the cost of managing their diabetes thanks to their income, their insurance, or both. Other patients shared their struggles keeping up with the rising cost of insulin. Struggles that are truly life-threatening, as you will read in the USA Today article shared above. For example, patients are rationing their use to lower their costs, all at the expense of their health. Poorly controlled glucose will cause their A1C to rise, and ultimately triggering a wide range of health problems, including loss of vision. Loss of vision from a problem called diabetic retinopathy, which can range from partial vision loss (called low vision) all the way to total blindness.
I’ve also been somewhat shocked as to how little education many of my patients with diabetes have received from their physicians. Education on diet, exercise, and what I term as “the most important job they have today” – keeping their glucose reading steady and low, with a focus on getting their A1C down to the levels recommended by their doctors (usually an A1C reading of 6.1, but this number is continually scrutinized).
Secondly, at my home, our 15-year old kitty, Julie, was recently diagnosed with diabetes, and my wife Sue and I are now familiarizing ourselves with managing glucose levels, insulin shots twice a day, and restricted diet. Of course this is no comparison to what patients go through, but it was a bit of a shock. The first time I went in to my local pharmacy to purchase my first bottle of insulin for $184, floored me. That little bottle that lasts 28 days, which I will only use 10% of due to the tiny size of my kitty Julie.
Finally, a couple weeks ago a long-term friend came to visit with Sue and I from South Africa. We spent a great weekend showing her around Southern California, while she educated me on her life as an insulin-dependent person with diabetes. She shared that during the recent US government shutdown, she and many of her friends from around the world were sending either money, or actual insulin, to US residents who could not pay for their insulin due to their layoffs. To say the least, I was in shock. We’re the USA! This is insulin! A drug created nearly 100 years ago, and one that without it patients will die.
I don’t profess to have any answers to the issue of the cost, but I have a newly-expanded understanding of the economic issues surrounding insulin, and the pharmaceutical companies. It truly tears at my heart when a patient tells me their A1C is at sky-high levels, and it is primarily due to a lack of understanding about the horrible effects of poorly controlled diabetes, compounded by the fact they are often rationing their insulin to be able to pay bills and buy groceries, putting their vision and total health at risk.
So if you’re reading this as either a person with diabetes or a friend/relative of someone with diabetes, please remind them of a few rules for their own self-care:
- Keep your A1C at or under the goal established by your managing physician.
- Get your eyes dilated yearly, and more frequently if your glucose is poorly controlled
- Quit smoking
- Follow a diabetic diet plan.
Dr. Lou Lipschultz